Regulação atuarial nos planos de saúde: um estudo dos padrões de reserva por meio dos indicadores financeiros

Abstract

The objective of the research was to analyze how financial indicators can present reserve patterns in health plan operators regulated by the actuarial regulation of the National Supplementary Health Agency. The method used to conduct the study, in terms of approach, was classified as quantitative, in terms of objectives, descriptive and in terms of procedures, documentary. The study of the financial indicators of health plan companies in the period from 2018 to 2023 indicated aspects regarding the solvency, solvency limit and contingency supplies of these operators. Operators such as SulAmérica and Amil continued to have the highest and most stable solvency rates throughout the year. In terms of solvency limit, operators such as NotreDame and Hapvida showed continuous progress in this indicator. Considering the contingency reserves, the companies Amil, Unimed and Bradesco showed greater exposure to regulatory and litigation threats. The indices showed that, with regard to the level of standardization of entities in relation to ANS regulations, only companies such as Amil, Notredame and Bradesco presented medium to high results, presenting themselves as more standardized with the regulation of reserves established by ANS, representing 33.33% of the sample used in the study. Based on the results, the study concluded that it is necessary for companies to improve their financial management practices to comply with ANS regulations and that, in order for the regulatory agency to achieve better results in relation to what is provided for in the regulation, it needs to act more consistently, such as carrying out more frequent inspections, since in these actions ANS can demand compliance with the regulation by companies. This requirement refers to the need for companies to adapt to the regulations through good financial management practices, seeking to guarantee the sustainability of the sector and the safety of beneficiaries.